Lawmakers plan to fill Medicaid funding hole

Posted November 8, 2011

N.C. Department of Health and Human Services

— North Carolina lawmakers said Tuesday that they wouldn't push for deep cuts to social service programs to balance a projected $139 million shortfall in the state Medicaid program.

Department of Health and Human Services officials told lawmakers last month that the agency couldn't make the $356 million in cuts required in the state budget because lawmakers overestimated some cuts that have to be approved by the federal government.

That process takes months, officials said, but budget writers calculated the savings as if they had started immediately. Other requested cuts would break Medicaid program rules, which could cost the state millions in federal revenue, officials said.

"I don't have the money within HHS to be able to make up that hole this year," Health and Human Services Secretary Lanier Cansler told a legislative oversight committee on Tuesday.

About 1.5 million state North Carolina residents – mostly poor children, older adults and the disabled – receive Medicaid coverage.

Unless lawmakers find more money for Medicaid, Cansler said, he would be forced to eliminate many adult services, like hospice care and mental health care, which aren't required by federal law. The state also could reduce reimbursements to physicians who treat Medicaid patients by up to 20 percent, he said.

Legislative leaders told him not to make those cuts.

"We are not going to cut services, and we are not going to cut rates to make up for one-time liabilities," said state Rep. Nelson Dollar, R-Wake.

DHHS Secretary Lanier Cansler Medicaid funding shortfall won't mean service cuts

Tracy Colvard, who represents home-care and hospice workers, said he was relieved to hear those programs wouldn't be cut.

"You talk about somebody at the end of life, needing that care, and all of the sudden they can't get it paid for by Medicaid – it's a scary thought," Colvard said.

Still, the details of the state's plan to fund Medicaid are fuzzy.

Dollar couldn't say how much money the state would supply. Lawmakers have reserves of about $450 million, but a lot of that money will be needed for Hurricane Irene relief and other budget areas also have shortfalls.

Cansler said he worries about even bigger problems as Congress trims its budget.

Many North Carolina health programs rely on federal grants. The state's food stamp funding, for example, was cut by $27 million in September, and huge cuts to more grants could be on the horizon.

"We're nervous, and we're watching closely what they're going to do," Cansler said. "Everything we normally get is budgeted. So, even though we're working with the Medicaid budget (and) we're working with the other pieces of the budget, if you start losing those federal grants that we anticipated, then we've got to continue finding a way to pare things back."


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  • jason19 Nov 11, 2011

    "As a rule, gov't employees, especially union gov't employees, are greedy and self serving, over paid,..."

    Says the uneducated bumpkin. Some people on this comment section absolutely amaze me with their ignorance and obliviousness of what happens in the real world. Government employees are no different than private-sector employees; *everyone* just wants to feed their families and have a decent living. *You* could also be a government employee if you chose to be since, to my knowledge, you're not born into being a government employee. With that in mind, I guess that makes you greedy, self-serving, and overpaid, as well right? If government employees have it so great, BE ONE.

  • Mark Hayes Nov 8, 2011

    IMHOO5."Truly ineligible" That just about sums it up,the burden from those that found it much cheaper to manipulate the programs designed for those in need has limited the funds and the number of legal citizans that are entitled,it's not our entitlement programs,it's the lack of control we are short on.

  • IMHO05 Nov 8, 2011

    Cut down on fraud and only offer the aid to those who are truly eligible. Get the slackers off their duffs to start supporting themselves. You will save millions just by getting rid of those that are truly ineligible for these benefits. They weigh the system down with ER visits for a cold and demand everything free!

  • whatusay Nov 8, 2011

    mountainlover.... I don't agree with tax payers bailing out unions....private sector or government. How hard is that to understand. Who bailed out GM and Chrysler???

  • mountainlover Nov 8, 2011

    whatusay: Unions in car companies are one example that I used. There are unions in the airline industry. There are unions in professional sports. None of them are employed by the government; however, someway, somehow, you will blame their existence on Obama. Anyone who believes that everything is President Obama's, President Bush's or any other President's fault has ceased to think.

  • mountainlover Nov 8, 2011

    "mountainlover, get a grip....as a whole gov't employees make more than private sector doing the same job."

    Is that so? We lost an employee today who got TWICE the amount he was making with us in the private sector. Your talk doesn't "wash" with me, because I know WHY we lose our employees.

  • Mark Hayes Nov 8, 2011

    There is a certain degree of greed in all of us it's not seperated by union or non union but brought on by the very society we live in,it's our nature to want more,thats a form of greed.

  • whatusay Nov 8, 2011

    mountainlover, get a grip....as a whole gov't employees make more than private sector doing the same job.

  • whatusay Nov 8, 2011

    mountainlover.... The unions for American car companies would no longer exist if Obama had not bailed them out, and then gave them an exemption on Obama Care. Obama needs unions to get re-elected, and he knows it.

  • trying2understand Nov 8, 2011

    The support system is very flawed, if you work forty hours a week and barely make ends meet to live day to day, you make to much for assistance but cant afford health insurance. Where as if you have a bunch of kids they are taken care at the expense of everyone else. I say you limit assistance to the first child and place the responsibility and the choice on the parents to decide if they can support the costs of additional children themselves.